Direct and indirect costs of nonfatal road traffic injuries in Iran: A population-based study

Objectives: The objective of this study was to assess the incidence rate as well as direct and indirect costs of nonfatal road traffic injuries (RTIs) in Iran in 2011.

Methods: Data from the 2011 national household survey were used. In this survey, data on demographics, history, and costs of injury were obtained in 2 steps: first, direct face-to-face interview and second, telephone calls. We estimated the incidence rate of nonfatal RTIs in this year. The direct costs included medical care as well as nonmedical costs paid by the patient or insurance services. The indirect costs were estimated by considering the cost of absence from work or education. We also used logistic regression analyses to investigate risk factors of nonfatal RTIs.

Results: We found 76 nonfatal RTI cases (0.96%) out of 7,886 whole reference study cases. These 76 injured patients had a history of RTI in the preceding 3 months. The annual incidence of RTIs was estimated at 3.84%. The mean age of RTI cases was 28.5 ± 10.6 and 88.16% of them were male. Male gender was a major risk factor (odds ratio [OR] = 9.64, 95% confidence interval [CI], 4.79–19.41) and marriage was a protective factor (OR = 0.44, 95% CI, 0.28–0.70) for RTI. The medians of direct, indirect, and total costs were US$214, US$163, and US$387, respectively. The total cost of nonfatal RTIs in Iran was estimated at 1.29% of the gross domestic product (GDP) in 2011.

Conclusions: In Iran, nonfatal RTIs imposed a total cost of almost US$7 billion to the country for one year. Extension and more serious implementation of preventive measurements seem necessary to decrease this notable burden of RTIs.     

Mandatory child restraint laws: Impact on childhood injuries due to traffic crashes

Research has indicated that laws requiring use of restraint devices for young children traveling in automobiles have had significant effects in increasing restraint use and reducing crash-related childhood injuries. This study examined dimensions along which the effectiveness of Michigan's April 1982 mandatory child restraint law varied. All children involved in motor vehicle crashes in Michigan from January 1978 through December 1982 were analyzed using multivariate intervention analysis methods. Research revealed that the effectiveness of the law in reducing childhood injuries was primarily due to reductions in less severe injuries occurring in crashed vehicles experiencing low to moderate levels of damage. Furthermore, the mechanism for the law's effects was not simply an increase in restraint use. In addition, the number of children riding in the more dangerous front-seat and cargo-area positions apparently decreased following implementation of the law, with children increasingly riding in the safer rear-seat position.     

Socioeconomic background and road traffic injuries: a study of young car drivers in Sweden

The aim of this study is to explore the manner in which different measures of original socioeconomic position (SEP) influence road traffic injuries (RTIs) among young car drivers in Sweden. The study consists of young people age 16-23. Subjects were taken from the Swedish Population and Housing Census of 1990 (n=727,995), and followed up by a search for cases of injury to car drivers in Sweden's National Hospital Discharge Register over the years 1991-96 (n=1,599). Household SEP was measured using social class, education, and disposable income. Relative risks were estimated by Poisson regression and population attributable risks were computed for each measure of SEP. Children of unskilled workers, of the self-employed, and of farmers, as well as children of parents with compulsory education only showed an increased risk of injury as car drivers compared to children in the highest socioeconomic group and children of highly educated parents. By contrast, level of household disposable income was found not to vary with RTI among young drivers. Twenty-five percent of the injuries could be avoided if all young people had the injury rate of the highest socioeconomic group, and 29% if all young people had the injury rate of those with highly educated parents. The reduction of risk differences based on household SEP calls for consideration of factors related to both differential exposure and differential susceptibility, which may be addressed in driver education.     

Epidemiology and patterns of facial fractures due to road traffic accidents in Taiwan: A 15-year retrospective study

Objective: The facial region is a commonly fractured site, but the etiology varies widely by country and geographic region. To date, there are no population-based studies of facial fractures in Taiwan.

Methods: We conducted a retrospective study of patients diagnosed with facial fracture and registered in the National Health Insurance Research Database of Taiwan between 1997 and 2011. The epidemiological characteristics of this cohort were analyzed, including the etiology, fracture site, associated injuries, and sex and age distributions.

Results: A total of 6,013 cases were identified that involved facial fractures. Most patients were male (69.8%), aged 18–29 years (35.8%), and had fractures caused by road traffic accidents (RTAs; 55.2%), particularly motorcycle accidents (31.5%). Falls increased in frequency with advancing age, reaching 23.9% among the elderly (age > 65 years). The most common sites of involvement were the malar and maxillary bones (54.0%), but nasal bone fractures were more common among those younger than 18 years.

Conclusion: Most facial injuries in Taiwan occur in young males and typically result from RTAs, particularly involving motorcycles. However, with increasing age, there is an increase in the proportion of facial injuries due to falls.     

我国道路交通安全教育培训思考

统计数据显示,我国2007-2009年道路运输事故呈下降趋势。但道路运输事故造成的死亡人数远远高于煤炭事故造成的死亡人数,道路交通安全形势依然很严峻。交通安全形势严峻的主要原因之一就是人为因素,加强对交通参与者的相关教育培训,提高安全意识,规范安全行为,是改善交通安全形势的根本途径。本文系统分析了我国的安全教育环境、交通文化、交通安全法律法规及交通安全教育培训存在问题,提出了改善我国交通安全教育的措施及建议。     

Comparison of epidemiology and injury profile between vulnerable road users and motor vehicle occupants in road traffic fatalities

Objective: Road traffic injuries (RTIs) are a major global health issue causing a global burden of mortality and morbidity. Half of all fatalities on the world’s roads are vulnerable road users (VRUs). The targeted intervention strategies based on fatality analysis focusing on VRUs can effectively contribute to reducing RTIs. This study aimed to compare VRUs and motor vehicle occupants (MVOs) in terms of epidemiology and injury profile.

Methods: We utilized a nationwide, prospective database of RTI-related mortality cases for patients who visited 23 emergency departments between January 2011 and December 2015. All fatalities due to RTIs in the prehospital phase or in-hospital were eligible, excluding patients with unknown mode of transport and those admitted to general wards. The primary and secondary outcomes were fracture injuries and visceral injuries diagnosed using the International Classification of Diseases, Tenth Revision (ICD-10). We compared fracture injuries between VRUs and MVOs using Abbreviated Injury Scale (AIS) 2? and 2+ classification.

Results: Among a total 3,694 road traffic fatalities (RTFs), 43.3% were pedestrians, followed by MVOs (27.0%), motorcyclists (18.9), bicyclists (6.6%), and agricultural vehicle users (4.2%). The elderly (>60 years old) accounted for 54.9% of VRU fatalities. RTFs occurred most frequently in the autumn and the VRU group and the MVO group showed significant differences in weekly and diurnal variation in RTFs. The injury severities (AIS 2+) of the head, neck, and thorax were significantly different between the 2 groups (P?Conclusions: Elderly pedestrians should be targeted for decreases in RTFs, and road traffic safety interventions for VRUs should be made based on the analysis of temporal epidemiology and injury profiles of RTFs.     

英国城市交通安全管理的调查与思考

从科学管理的角度,总结分析了英国城市道路交通安全管理工作的经验:科学的道路规划网络,清晰的道路语言,完善的道路交通设施,前瞻的事故预防体系,健全的机动车管理制度,高效的停车管理措施,畅通的公路交通动脉,严格的执勤执法。在调查的基础上,结合我国道路交通状况及交通管理部门的工作实际,提出了加强我国城市道路交通科学管理的对策措施,为我国城市特别是中等以上城市治理交通拥堵、提高道路交通利用率提供了借鉴经验。     

Reality and risk of contact-type head injuries related to bicycle-mounted child seats

Objective

The authors have treated numerous children who have been injured by falling from bicycle-mounted child seats. Despite the greatly increased use of such seats, the understanding of their risk and the importance of helmet use remains alarmingly poor. The objective of this study was to confirm the risk of bicycle-mounted child seats and to evaluate the efficacy of helmets, seat belts, and back seat height in terms of preventing or mitigating contact-type head impacts that occur in falls from bicycle-mounted child seats.

Materials and methods

Biometrical dummy tests were performed to examine contact-type head injuries in falls from stationary bicycles. A bicycle with an anthropometric test dummy placed in a bicycle-mounted child seat was tipped over. Each test was repeated three times and three-dimensional acceleration was measured using accelerometer. Head Injury Criteria (HIC) were calculated and the respective influences of a helmet, a seat belt, and increased height of the back of the seat on such impacts were evaluated.

Results

Only helmets unequivocally lowered maximal acceleration and/or HIC values with statistical significance. The seat belt lowered HIC values as long as it was used with the high-back seat. Only when the dummy wore a helmet sitting in a high-back seat did the HIC show less than the threshold of 570 for three-year-old children. The HIC showed the lowest score of 161.5 when the dummy wore both a helmet and a seat belt sitting in a high-back seat.

Conclusions

Riders in bicycle-mounted child seats definitely have higher risks of contact-type head injuries. In transporting a child on a bicycle-mounted child seat, parents must use both a child-bicycle helmet and a high-back child seat at least; a seat belt is highly recommended as long as it is used with the other safety devices.

Impact on Industry

The bicycle-mounted child seat should have a high enough back and an appropriate seat belt to protect the head of the child from a contact-type injury.     

Road traffic injuries to foreigners in the People's Republic of China, 2000-2008

Introduction: China's rapid motorization has resulted in significant challenges in road safety. Method: Using official national statistics, this study examines road traffic injuries (RTIs) experienced by foreigners in China. The number of foreigners entering China has increased 2.4 times over the study period, from 10.16 million in 2000 to 24.33 million in 2008. Results: From 2000- 2008, the number of road traffic fatalities among foreigners similarly increased 2.5 fold, including 49 fatalities reported in 2008. Nonfatal RTIs during this same time frame increased by a magnitude of 1.8 (126 nonfatal injuries in 2000 to 223 in 2008). Conclusions: This study suggests that the total number of foreigners working or visiting China each year who suffer fatal and nonfatal road traffic injuries is relatively low. Impact on Industry: This study provided evidence suggesting that foreigners visiting or working in China face a relatively low risk of road traffic injuries.     

Field data: a study on trend and prediction of fatal traffic injuries prevalence in Shanghai

OBJECTIVE: The main objectives of the study are to analyze fatal traffic-injury trends in 1987-2003 in Shanghai and predict its prevalence in near future and provide scientific data for the local governmental decision on developing practical working methods on traffic-injury prevention and control. METHODS: In this study, epidemiological method and Grey dynamic model GM (1,1) were introduced to analyze and forecast traffic-injury mortality rates respectively. RESULTS: There was an apparent increasing trend of traffic-related injuries in Shanghai from 1987 to 2003 with the rate of growth in motorization. The average rates of annual increase are 3.59% in fatalities (from 7.78 per 100,000 population to 14.18 per 100,000 population) during the period. Pedestrians were the most common type of victims (29.6%), followed by bicyclists (25.1%), and motorcyclists (24.1%). Males accounted for the majority of all victims, over 69%. The population of high-school and lower high-school education level represented 66.4% victims of total road-traffic injuries. And if no special factors effect its development, the traffic fatalities would be up to 17.84 per 100,000 population in 2010, when calculating from equations we found and validated Y(t) = 359.90 x e0.027(t-1)-352.13, (t = 1, 2, ..., N) for Shanghai. CONCLUSION: Our data indicate the risk of fatal traffic injuries has increased in recent years and will go on growing in the near future in Shanghai. The findings showed that Grey dynamic model GM (1,1) is eligible on the prediction and can be a tool for injuries forecasting, implementing effective policies, programs, and interventions for reducing traffic injuries in the big cities.     

北京城市污泥大颗粒低温热干化效率研究

污泥热干化工艺的高运行成本制约着该工艺在我国的推广.为确定污泥低温热干化的最佳效率条件,提供节约热干化工艺成本的理论基础,以北京市城市污泥为样品对低温热干化进行了模拟试验.比较了不同温度(125℃、150℃、175℃、200℃)、不同比表面积(柱形、饼形、球形)的大颗粒污泥的干化速率,并试验了有无流动气氛两种环境条件.结果表明,污泥热干化大致分为3个阶段:升速阶段、匀速阶段和降速阶段.3种形状中,饼形污泥的干化效率最好;干化效率点在125～150℃;提出了修正的Page模型,并且通过参数分析得到了低温热干化的温度效率拐点,佐证了效率点温度在140℃左右;流动气氛会进一步提高脱水效率.污泥热干化尾气释放特性一直是研究难点,用土壤中VOC的监测方法发现,新鲜污泥中的VOC能被准确监测,但经过加热干化后的尾气中的有机成分剧增,而且难以使用GC/MS定性.     

城市燃气管网脆弱性评价及其应用

为研究城市燃气管网系统的本质安全性,提出了适用于城市燃气管网系统的脆弱性概念及脆弱性研究思路。根据城市燃气管网自身的行业特点与实地调研结果,从物理、结构和社会功能3个角度出发,建立了城市燃气管网脆弱性指标体系及等级标准。然后通过MATLAB R2010a的BP神经网络方法分别训练"敏感性程度"和"自身应对能力"网络模型,并构建脆弱性的函数模型。最后将城市燃气管网脆弱性等级划分为5个,用于评价城市燃气管网的脆弱性程度。训练得到的网络模型的均方差均小于0.05,结果表明,训练得到的网络模型效果良好,具有较强的泛化能力,且能够方便地用于评价未知样本,得到研究区域的燃气管网脆弱性等级值为0.91,研究区域的燃气管网脆弱性被评定为"不脆弱"。